Effectiveness of smoking cessation treatment and predictors of success in patients with severe mental illnesses

First published: 10 May 2019 | Last updated: 20 May 2019

Aims  Adults with severe mental illnesses (SMI) have an approximately three times greater smoking prevalence than the general population, leading to premature morbidities and reduced life expectancies. Despite this, perceived barriers such as low rates of success discourage clinicians from offering smoking cessation treatment to this population.  This study aimed to assess the effectiveness of smoking cessation interventions and identify possible predictors for successful smoking cessation attempts.

Methods  Routine clinical data of 118 patients with histories of SMI treated at a smoking cessation clinic in the Czech Republic during 2008-16 were analysed. Logistic regression was used to assess associations between abstinence at 1-year follow-up and socio-demographics, current SMI status, smoking characteristics and treatment characteristics.

Results  The overall rate of abstinence was 22.9% (27/118). The presence of current SMI in 59 patients did not significantly affect abstinence (p=0.72). Varenicline (OR=0.80, 95% CI: 0.19-3.43) and nicotine replacement therapy (OR=1.31, 95% CI: 0.37-4.68) showed no detectable benefit over non-pharmacological therapy. Abstinence was higher among patients with greater number of visits (OR= 1.20, 95% CI: 1.06-1.37). A higher level of tobacco dependence was negatively associated with abstinence, measured by number of cigarettes per day (OR=0.92 95% CI: 0.82-0.97) and FTND scores (N=113, OR=0.62; 95% CI: 0.48-0.81). No other significant associations between demographic factors and abstinence were found.

Conclusions  In a sample of patients with a history of severe mental illness who received support to stop smoking, those currently experiencing mental illness were just as likely to achieve long-term abstinence from smoking as other patients.


Dr. Leonie S Brose National Addictions Centre, Institute of Psychiatry, Psychology and Neuroscience, King ‘s College London, 4 Windsor Walk, London, SE5 8BB, UK

Conflicts of interest:

No conflict of interest

Mr Hyun Seok Lee